Primary Pneumococcal Peritonitis in Patients with Cardiac Ascites: Report of 2 Cases

Two patients with fatal spontaneous pneumococcal peritonitis associated with ascites due to severe heart failure are reported. Remarkable clinical features included gradual onset and absence of fever and signs of peritonitis. Only 1 case of spontaneous bacterial peritonitis associated with cardiac ascites was described previously and was caused by enterococcus.